Clinical Audit Response Specialist

Job Summary

Detail-oriented and analytical, the full-time Clinical Audit Response Specialist will support accurate and compliant responses to payer audits and appeals while collaborating with cross-functional teams in a hybrid work environment based in Portsmouth, NH.

Key responsibilities

• Review and respond to commercial and governmental payer audits in a timely and compliant manner
• Analyze medical records and prepare documentation for audit responses and appeals
• Coordinate with internal teams to gather necessary documentation for submissions and track audit activity

Required qualifications

• Ability to review and interpret medical records and payer requests
• Strong written and verbal communication skills for preparing appeal documentation
• Experience managing multiple deadlines while ensuring accuracy and compliance
• Familiarity with Microsoft Office products
• Commitment to maintaining confidentiality and compliance with regulatory standards